The state's insurance-linked healthcare scheme has not been able to fulfill its main objectives of reducing patients' “out of pocket“ expenses or improve healthcare access in rural areas.

This is the finding of a revi
ew done by the Centre For Enquiry into Health and Allied Themes (CEHAT) of the Mahatma Jyotiba Phule Jeevandayee Arogya Yojana (MJPJAY), until April 1 called the Rajiv Gandhi Arogya Yojana. Families with an annual income of less than Rs 1 lakh are eligible for the scheme.

“Of 473 hospitals empanelled in 2014, 84% belonged to the private sector,“ said the CEHAT study , made public on Tuesday . It found 44% of the private hospitals are in six urban centres. “Only 12% of empanelled hospitals are found in the least urbanized districts,“
said Sangeeta Rege of CEHAT.Dr Ravi Duggal of International Budget Partnership said, “The state has chosen to take an insurance path to provide healthcare access. It could have chosen to have a corpus of funds, like Karnataka has done.“ He said Maharashtra pays a premium of Rs 800 crore per year to an insurance company .
“Less than half is used in providing care. So why can't state utilise the premium sum in improving hospital network,“ he asked. The study found specialties such as radiation oncology are absent in private network hospitals in tribal and least urbanized districts. Plus, “most grievances are about out of pocket expenses,“ it stated.